Keloid folliculitis

Folliculitis keloidalis, also known as folliculitis keloidalis nuchae or acne Keloidalis nuchae, is a chronic skin disease characterized by inflammation and subsequent scarring in the neck area, especially the back of the head. This condition is most common in men of African descent, but can affect people of all ethnicities. The exact cause is unknown, but a combination of hair shaving, skin friction, genetics, and possibly bacterial infections are thought to play a role.


Symptoms of keloidal folliculitis may include:

  • Initially small, firm, round nodules on the back of the head or neck that may be itchy or painful.
  • Over time, these nodules can coalesce into larger, raised scars (keloids), which are permanent and can be cosmetically bothersome.
  • Hair loss in the affected area.
  • Occasional inflammation, redness and pus formation.


Treatment for keloidal folliculitis aims to reduce inflammation, prevent progression of the disease, and improve the cosmetic appearance. However, complete healing is difficult and treatment can be lengthy. Treatment options include:

  • Topical steroids : To reduce inflammation.
  • Antibiotics : Topical or oral antibiotics may be prescribed for bacterial infection.
  • Intralesional steroid injections : Injected directly into scars to reduce inflammation and minimize scarring.
  • Laser therapy : Can be used to reduce scarring and treat the inflamed follicles.
  • Surgical removal : In severe cases, surgical removal of affected skin and subsequent skin grafting may be necessary.

Prevention measures

  • Gentle hair removal : Avoid close shaving and frequent shaving to minimize skin irritation.
  • Avoiding friction : Wear loose-fitting clothing to avoid friction in the neck area.
  • Hygiene : Regular cleaning of the affected area can help prevent bacterial infections.

Important to note

Since keloidal folliculitis can lead to permanent scarring and can be psychologically stressful, it is important to see a dermatologist at the first signs of the disease. Early intervention can help slow progression and improve quality of life.

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